Coronavirus spreads in Nagorno-Karabakh amid heavy fighting

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Coronavirus patients lie in an infectious diseases clinic in Stepanakert, in the separatist region of Nagorno-Karabakh, Tuesday, Oct. 20, 2020.Nagorno-Karabakh, which lies within Azerbaijan but has been under the control of ethnic Armenian forces since a war there ended in 1994, faces an outbreak of the coronavirus amid the largest outbreak of hostilities in more than a quarter-century. (AP Photo)

STEPANAKERT, Nagorno-People who are sick with the coronavirus pack into chilly basements alongside the healthy to hide from artillery fire. The local health minister who tested positive keeps working, despite a fever and pneumonia. Doctors with the virus perform surgery on the wounded.

These are the grim realities of the pandemic in Nagorno-Karabakh, a separatist region in the South Caucasus mountains beset by weeks of heavy fighting between Armenian and Azerbaijani forces.

“We just don’t have time to think about coronavirus,” said Irina Musaelyan, a resident of the regional capital of Stepanakert who was sheltering in a basement with her neighbors.

Nagorno-Karabakh lies within Azerbaijan but has been under the control of ethnic Armenian forces backed by Armenia for more than a quarter-century. It is facing the largest escalation of fighting since a war there ended in 1994, with hundreds killed since Sept. 27. Two attempts at cease-fires have failed.

The fighting has diverted the region's scarce resources from containing the virus, which spread unchecked amid artillery fire and drone attacks that have people spending many hours in overcrowded bunkers, whether they are sick or healthy. Contact tracing has ground to a halt.

Health care workers have been hit particularly hard.

“Almost everyone got infected. Some had it in a light form and others in a more serious one,” Dr. Malvina Badalyan, head of the infectious disease clinic in Stepanakert, said of the region's health workers.

But in the middle of a war, with wounded flooding into hospitals, there's nothing to do but keep working.